II 

118TH CONGRESS 

2D SESSION S. 3921 

To amend title XIX of the Social Security Act to provide a higher Federal 

matching rate for increased expenditures under Medicaid for behavioral 

health services (including those related to mental health and substance 

use), and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MARCH 12, 2024 

Ms. SMITH (for herself and Ms. STABENOW) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

A BILL 

To amend title XIX of the Social Security Act to provide 

a higher Federal matching rate for increased expenditures under Medicaid for behavioral health services (including those related to mental health and substance 

use), and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Medicaid Bump Act’’. 


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1 SEC. 2. HIGHER FEDERAL MATCH FOR INCREASED EX2 PENDITURES UNDER MEDICAID FOR BEHAV3 IORAL HEALTH SERVICES. 

4 (a) IN GENERAL.—Section 1903 of the Social Secu5 rity Act (42 U.S.C. 1396b) is amended— 

6 (1) in subsection (a)(5)— 

7 (A) by inserting ‘‘(A)’’ before ‘‘an amount 

8 equal to’’; 

9 (B) by inserting ‘‘and’’ after the semicolon; 

10 and 

11 (C) by adding at the end the following: 

12 ‘‘(B) subject to subsection (b)(6), an amount equal 

13 to 90 percent of the amount by which— 

14 ‘‘(i) the sum of the amounts expended during 

15 such quarter which are attributable to the offering, 

16 arranging, and furnishing (directly or on a contract 

17 basis) under the State plan (or under a waiver of 

18 the plan) of behavioral health services (including 

19 those related to mental health and substance use); 

20 exceeds 

21 ‘‘(ii) the sum of the amounts expended during 

22 the corresponding quarter in the 4-quarter period 

23 ending on March 31, 2019, which are attributable to 

24 the offering, arranging, and furnishing (directly or 

25 on a contract basis) under the State plan (or under 

26 a waiver of the plan) of such services; plus’’; and 


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1 (2) in subsection (b), by adding at the end the 

2 following new paragraph: 

3 ‘‘(6) ACCOUNTABILITY AND MAINTENANCE OF EF4 FORT REQUIREMENTS FOR ADDITIONAL FEDERAL FUND5 ING FOR INCREASED EXPENDITURES FOR BEHAVIORAL

6 HEALTH SERVICES.—As a condition for receiving the 

7 funds the Secretary is otherwise obligated to pay to a 

8 State under subsection (a)(5)(B), a State shall meet the 

9 following requirements: 

10 ‘‘(A) SUPPLEMENT, NOT SUPPLANT.—The 

11 State shall use the funds received under such sub12 section to supplement, not supplant, the level of 

13 State funds expended for the offering, arranging, 

14 and furnishing (directly or on a contract basis) 

15 under the State plan (or under a waiver of the plan) 

16 of behavioral health services (including those related 

17 to mental health and substance use) through pro18 grams and activities in effect as of April 1, 2021. 

19 ‘‘(B) USE OF FUNDS FOR ACTIVITIES THAT IM20 PROVE DELIVERY OF BEHAVIORAL HEALTH SERV21 ICES.—The State shall use the funds received under 

22 such subsection for activities that increase the ca23 pacity, efficiency, and quality in the provision of be24 havioral health services (including those related to 

25 mental health and substance use) delivered by proVerDate Sep 11 2014 04:05 Mar 19, 2024 Jkt 049200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S3921.IS S3921

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1 viders, including through increases in payment rates 

2 for providers of those services and the adoption of 

3 other measures that ensure a reduction in staff 

4 turnover.’’. 

5 (b) SUB-REGULATORY GUIDANCE.—Not later than 

6 180 days after the date of enactment of this Act, the Sec7 retary of Health and Human Services shall issue sub-regu8 latory guidance to States specifying the services that are 

9 behavioral health services for purposes of subparagraph 

10 (B) of section 1903(a)(5) of the Social Security Act (42 

11 U.S.C. 1396b(a)(5)), as added by subsection (a)(1). 

12 (c) EFFECTIVE DATE.—The amendments made by 

13 this section shall apply with respect to calendar quarters 

14 beginning on or after January 1 of the year that begins 

15 1 year after the date of the enactment of this Act. 

16 SEC. 3. REPORT REGARDING BEHAVIORAL HEALTH SERV17 ICE. 

18 Not later than 1 year after the date of enactment 

19 of this Act, and annually thereafter, the Secretary of 

20 Health and Human Services shall submit to the Com21 mittee on Energy and Commerce of the House of Rep22 resentatives and the Committee on Finance of the Senate 

23 a report regarding behavioral health services (including 

24 those related to mental health and substance use) provided 

25 under title XIX of the Social Security Act (42 U.S.C. 


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1 1396 et seq.) in each State (as such term is defined in 

2 section 1101(a) of such Act (42 U.S.C. 1301(a)) for pur3 poses of such title), specifying the payment rates for such 

4 services, the rationale for deriving such payment rates, 

5 and utilization of such services, as such data are available. 

Æ 


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